Altitude Sickness

Question 1

What are the three main types of altitude related disorder?

Answer 1

Acute mountain sickness (AMS) which may progress to high altiture pulmonary oedema (HAPE) or high altitude cerebral oedema (HACE).

Question 2

What is the cause of altitude sickness?

Answer 2

Chronic hypobaic hypoxia which happens at high altitudes

Question 3

What are the features of acute mountain sickness?

Answer 3

Headache
Nausea
Fatigue

Occuring at 2,500-3000m, developing over 6-12 hours and potentially lasting a number of days.

Question 4

How can AMS be prevented?

What is the treatment?

Answer 4

Gain altitude slowly
Acetazolamide

Descent

Question 5

What is the presentation of high altitude pulmonary oedema (HAPE)?

Answer 5

Presents as classic pulmonary oedema at 4000 + m

Question 6

What is the presentation of high altitude cerebral oedeam (HACE)?

Answer 6

Presents with headache, ataxia and papilloedema

Question 7

What is the management of HACE?

Answer 7

Descent

Dexamethasone

Question 8

What is the management of HAPE?

Answer 8

Descent

Nifedipine, dexamethasone, acetazolamide, phosphodiesterase type V inhibitors, oxygen if available.